Hypertensive disorders of pregnancy and midlife maternal cognition in a prospective cohort study

Author:

Birnie Kate12ORCID,Catov Janet34,Anderson Emma L.125,Lapidaire Winok6,Kilpi Fanny12,Lawlor Deborah A.12,Fraser Abigail12

Affiliation:

1. Population Health Sciences, Bristol Medical School Bristol UK

2. MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove Bristol UK

3. Department of Obstetrics and Gynecology University of Pittsburgh Pittsburgh Pennsylvania USA

4. Magee‐Womens Research Institute Pittsburgh Pennsylvania USA

5. Department of Mental Health of Older People Division of Psychiatry University College London London UK

6. Division of Cardiovascular Medicine Radcliffe Department of Medicine University of Oxford Oxford UK

Abstract

AbstractHypertensive disorders of pregnancy (HDP) are associated with an increased risk of cardiovascular disorders, with recent evidence linking pre‐eclampsia with vascular dementia. We examined associations of HDP with cognitive performance measured in midlife, in a prospective cohort study, the Avon Longitudinal Study of Parents and Children. Six cognitive function domains were measured 20 years after pregnancy at a mean age of 51 years. The cognition tests were repeated at clinics in the following two years. Cognitive function domains measured were immediate and delayed verbal episodic memory, working memory, processing speed, verbal intelligence, and verbal fluency. Exposures were pre‐eclampsia, gestational hypertension (GH), and a combined category of any HDP, all compared to normotensive pregnancy. Of 3393 pregnancies included in the analysis, GH was experienced by 417 (12.3%) and pre‐eclampsia by 57 (1.7%). GH was associated with lower verbal episodic memory, in the delayed logic memory test (‐0.16 SDs; 95% CI ‐0.30, ‐0.03; p = .015) and there was weak evidence of an association with the immediate logic memory test (‐0.13 SDs; ‐0.27, 0.001; p = .058). However, we did not see steeper declines by age for women with GH and there was no evidence of associations with other cognitive domains or for pre‐eclampsia with any domains. Results were not substantially changed after controlling for midlife blood pressure. Our findings suggest that a history of GH is associated with slightly reduced episodic memory 20 years after pregnancy, but we found no evidence of a quicker age‐related decline compared to women with normotensive pregnancies.

Funder

British Heart Foundation

Wellcome Trust

Medical Research Council

Publisher

Wiley

Subject

Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

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